Laparoscopic scaffold assembly

ABSTRACT

A scaffold assembly includes an instrument pod and a plurality of actuable movers. The instrument pod may include one or more instruments operably coupled thereto. The instrument pod is inserted through a tissue tract into the body cavity. Each actuatable mover includes an insertion member extending therefrom therefrom for insertion within tissue. Each mover has one or more lines removably attachable to the instrument pod that are configured to move the instrument pod between different positions relative to each mover upon the actuation of one or more of the movers to move the instrument pod within the body cavity.

CROSS REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of U.S. Provisional Application Ser.No. 61/266,994, filed on Dec. 4, 2009, the entire contents of which areincorporated herein by this reference.

BACKGROUND

1. Technical Field

This application generally relates to the field of minimally invasivesurgery. More particularly, the present disclosure relates to anassembly and a method for providing power, data, illumination, andinstrumentation into a body cavity.

2. Description of Related Art

Laparoscopy is a minimally invasive surgical procedure performed in theabdominal cavity. It has become the treatment of choice for severalroutinely performed interventions.

However, known laparoscopy technologies are limited in scope andcomplexity due in part to 1) mobility restrictions resulting from usingrigid tools inserted through access ports, and 2) limited visualfeedback. That is, long rigid laparoscopic tools inserted through smallincisions in the abdomen wall limit the surgeon's range of motion andtherefore the complexity of the surgical procedures being performed.Similarly, using a 2-D image from a typically rigid laparoscope insertedthrough a small incision limits the overall understanding of thesurgical environment. Current technology requires a third port toaccommodate a laparoscope (camera). Each new viewpoint requires anadditional incision and thus, more pain and scarring for the patient andan added effort for the surgeon.

SUMMARY

Accordingly, a scaffold assembly for minimally invasive surgery, e.g.laparoscopic surgery, is provided and includes an instrument pod and aplurality of actuable movers. The instrument pod may include one or moreinstruments operably coupled thereto. The instrument pod is configuredfor insertion through a tissue tract into a body cavity. In someembodiments, the instrument pod is configured to fit through a cannulaof an access device. The instrument pod may be configured to collapsefor insertion and then expand inside the body cavity. In someembodiments, the instrument pod is selectively movable between twomovers. In other embodiments, the instrument pod is selectively movablebetween three movers.

The instrument pod (support) can have an elongated configuration havingfirst and second opposing end portions and a line of a first of themovers is attached at the first end portion and a line of a second ofthe movers is attached at a second end portion. The plurality of moversin one embodiment can comprise three movers and the instrument pod canhave a substantially triangular configuration, a line of each of themovers attached adjacent a vertex of the instrument pod.

The plurality of actuable movers preferably each includes a cannulaextending therefrom for insertion within tissue. Each mover preferablyhas at least one line removably attachable to the instrument pod andconfigured to move the instrument pod between different positions withinthe body cavity relative to each mover upon the actuation of at leastone of the movers.

Each mover can be actuable manually, electrically or by other methods.Each manually actuable mover can include a handle or a knob. In someembodiments, a power source is operably connected to one or more of theelectrically actuable movers. The one or more instruments supported bythe instrument pod may include one or more of a camera, an illuminationsource, a grasper, a retractor, and a sensor. One or more movers mayinclude a rotatable spool operably associated with the one or morelines. The one or more lines may include one or both of a fiber opticwire/cable or an electrical wire/cable which operably couple to one ormore ports of the instrument pod. The one or more lines may be operablyconnected to a CPU controller. The one or more lines are preferablymovable through the cannula of one of the respective movers. The one ormore instruments are preferably selectively operable within the bodycavity.

In another aspect, a method of movably suspending an instrument podwithin a body cavity is disclosed which includes providing a scaffoldassembly including an instrument pod and a plurality of movers. Theinstrument pod includes one or more instruments operably associatedtherewith. Each mover includes a cannula and at least one line extendingtherefrom. The at least one line is selectively extendable andretractable from each respective mover. The method includes insertingthe instrument pod into a body cavity and attaching the at least oneline of one or more of the movers to the instrument pod while theinstrument pod and the at least one line is positioned within the bodycavity. The method further includes selectively extending or retractingthe one or more lines such that the instrument pod moves within the bodycavity.

In some embodiments, the method includes selectively moving theinstrument pod within the body cavity between two movers. In otherembodiments, the method includes selectively moving the instrument podwithin the body cavity between three movers. The method further includesselectively operating the one or more instruments within the body cavitywherein the one or more instruments may include one or more of a camera,an illumination source, a grasper, a retractor, and a sensor or thelike.

BRIEF DESCRIPTION OF THE DRAWINGS

The above and other aspects, features, and advantages of the presentdisclosure will become more apparent in light of the following detaileddescription when taken in conjunction with the accompanying drawings inwhich:

FIG. 1 is a perspective view of one embodiment of a laparoscopicscaffold assembly having a pair of movers and an instrument pod inaccordance with the present disclosure;

FIG. 2 is an enlarged perspective view, with parts separated, of theinstrument pod of FIG. 1;

FIG. 3 is a perspective view of the laparoscopic scaffold assembly ofFIG. 1 with the movers shown mounted to a patient's body and theinstrument pod shown inserted by a grasper through an access device intoa body cavity;

FIG. 4 is an enlarged perspective view illustrating the instrument podof FIG. 2 being attached to a line extending from one of the movers;

FIG. 5 is a perspective view of the laparoscopic scaffold assembly ofFIG. 1 illustrating the instrument pod being movably suspended withinthe body cavity between each mover;

FIG. 6 is a partial perspective view of one embodiment of an instrumentpod and a complimentary embodiment of a line of a mover in accordancewith the present disclosure;

FIG. 7 is a partial perspective view of another embodiment of aninstrument pod and a complimentary embodiment of a line of a mover inaccordance with the present disclosure;

FIG. 8 is perspective view illustrating an accessory light being hung ona line within a body cavity in accordance with the principles of thepresent disclosure;

FIG. 9 is a perspective view of another embodiment of an instrument podin accordance with the present disclosure;

FIG. 10 is a perspective view of another embodiment of a laparoscopicscaffold assembly including manual and electrical movers each having ananchor portion and a moving portion in accordance with the presentdisclosure;

FIG. 11 is an enlarged, perspective view, with parts separated, of thearea of detail of FIG. 10 showing the anchor portion and the movingportion of one of the movers;

FIG. 12 is an enlarged, partial side elevational view of the anchorportion of FIG. 10;

FIG. 13 is an enlarged, partial perspective view of one embodiment of aninstrument pod and a complimentary mover line;

FIG. 14 is an enlarged, partial perspective view of another embodimentof an instrument pod and a complimentary mover line;

FIG. 15 is a perspective view of one embodiment of an instrument pod inaccordance with the present disclosure.

FIG. 16 is a perspective view of another embodiment of an instrument podpositioned in a first condition in accordance with the presentdisclosure;

FIG. 17 is a perspective view, with parts separated, of the instrumentpod of FIG. 16;

FIG. 18 is a perspective view of the instrument pod of FIGS. 16 and 17positioned in a second condition for insertion through a cannula;

FIG. 19 is a perspective view of the instrument pod of FIGS. 16-18 shownpositioned within a body cavity; and

FIG. 20 is a perspective view of the laparoscopic scaffold assembly ofFIG. 1 shown as a kit in accordance with the present disclosure.

DETAILED DESCRIPTION

Various embodiments of the present disclosure will now be described indetail with reference to the drawings, wherein like reference numeralsidentify similar or identical elements. In the drawings and in thedescription that follows, the term “proximal,” will refer to the endthat is closer to the operator, while the term “distal” will refer tothe end that is farther from the operator.

Turning now to FIG. 1, one embodiment of a laparoscopic scaffoldassembly 100 includes an instrument pod 10 and two actuable movers 20.The instrument pod 10 includes a body portion 10 a having a pair ofcatches 12, 14 extending from the distal ends thereof. The instrumentpod 10 can have catches of any suitable shape such as a knob “K”illustrated in FIG. 6 or a curvilinear hook “H” illustrated in FIG. 7.As best shown in FIG. 2, the instrument pod 10 includes one or morereceptacles “R” that are configured to receive one or more instruments“I” (see FIG. 16) therein. Examples of such instruments “I” include, butare not limited to, clip appliers, graspers, dissectors, retractors,staplers, laser probes, illumination sources, photographic devices,endoscopes and laparoscopes, tubes, and the like. The instrument pod 10of FIG. 2 includes a plurality of instruments “I” affixed to the one ormore receptacles “R”, which are illumination sources (e.g., lightbulbs). However, other instruments “I” may be mounted therein such asthose discussed above and shown in FIG. 16. Some of these instruments(e.g. illumination sources such as light bulbs) may be powered by one ormore batteries 18 housed within the instrument pod 10 by a back plate 10b that is held in position by one or more screws 10 s. In addition, someof these instruments (e.g., photographic devices) operate oninput/output type signal transmission. Accordingly, the instrument pod10 may be configured to receive and send analog or digital signalsthrough wired or wireless transmissions which will be described ingreater detail hereinbelow.

Referring again to FIG. 1, each mover 20 includes a moving portion 30and an anchor portion 40. The moving portion 30 includes a base 32, acrank 34, a spool 36 and a line 38 in the form of a suture. The crank 34and spool 36 are rotatably mounted to the base 32. The line 38 isoperably coupled to the spool 36 such that upon rotation of the crank34, the line 38 extends and retracts with respect to the spool 36. Theline 38 has an attachment feature 38 a (e.g. a loop) disposed at thedistal end thereof. The attachment feature can be any suitable shapesuch as an integrally formed ring “N” shown in FIG. 6 or an adjustableloop “AL” shown in FIG. 7. The anchor portion 40 includes a platform 42for supporting the moving portion 30 and an insertion member in the formof a tubular member or cannula 44 extending therefrom for insertionwithin tissue through a tissue tract to access a body cavity “BC” (FIG.3). The line 38 is adapted for movement through the cannula 44 upon theselective retraction and/or extension of the line 38 of each mover 20.The laparoscopic scaffold assembly may be assembled in the form of a kit500 as illustrated in FIG. 20.

In use, shown best in FIGS. 3-5, each mover 20 is mounted to a patient'sbody “B” such that the cannula 44 extends into the body cavity “BC.” Theline 38 and attachment feature 38 a of each mover 20 are adapted formovement through the cannula 44 upon rotation of the crank 34 and theextension and retraction of the line 38. An access device “D” is thenmounted within the body cavity “BC.” With reference to FIG. 3, theinstrument pod 10 is then positioned in a vertically elongate conditionso that it may be inserted through a longitudinal passage “P” of anaccess device “D” via a grasper “G” or other appropriate surgicalinstrumentation such as first instrument “II1” or second instrument“II2.”

Once the instrument pod 10 is inserted through the longitudinal passage“P” and into the body cavity “BC”, the attachment feature 38 a of eachmover 20 is then removably attached to the catches 12, 14 of theinstrument pod 10 for movably suspending the instrument pod 10 in asubstantially horizontally elongate condition within the body cavity“BC.” As shown in FIG. 5, the instrument pod 10 can then be selectivelymovable between different positions (i.e. closer or further from one ofthe movers) relative to the movers 20 in response to the rotation thecrank 34 of each mover 20 and the extension and retraction of each line38. In this manner, the one or more suspended instruments “I” can beused in combination with the grasper “G” or other surgicalinstrumentation within the body cavity “BC.” In addition, an accessorylight or laparoscope “L” or other surgical instrumentation inserted intothe body cavity “BC” may be mounted on or placed on the line 38 withinthe body cavity “BC” for providing additional or enhanced surgicalbenefits, as illustrated in FIG. 8. The illumination or instrumentationattached to instrument pod 10 can be moved along the line 38 tohorizontally adjust their position by movement of the instrument pod 110by the respective crank 34.

With reference to FIGS. 9 and 10, an alternate embodiment of alaparoscopic scaffold assembly 200 is illustrated. The assembly 200includes an instrument pod 210 and a plurality of movers 220 such asmovers 220 a, 220 b, 220 c. The instrument pod 210 includes a pluralityof ports 212 (FIG. 9) disposed thereabout, e.g. at each of the vertices,for operably coupling to one or more lines 249 of the plurality ofmovers 220. The instrument pod 210 also includes one or more receptacles“R” on a lower surface (facing into the body cavity) adapted forreceiving one or more instruments “I” (e.g., an illumination source,camera, etc, such as received by instrument pod 400 of FIG. 16) therein.As shown in FIG. 9, the one or more receptacles “R” each has aninstrument “I” such as illumination source (e.g. light bulb) mountedtherein. However, other instruments “I” may be mounted therein such asthose discussed above and shown in FIG. 16 discussed below. In someembodiments, one or more of the plurality of ports 212 may be configuredto send or receive wired signals through fiber optic wires or electricalwires operably associated with the one or more lines 249 of the movers220. The fiber optic wires/cables or electrical wires/cables may beoperably connected to the one or more ports 212 via a communication portsuch as a universal serial bus (USB), serial ports, parallel ports, orother suitable electrical connections operably coupled thereto. In someembodiments, these signals may be manually or automatically controlledby a central processing unit. In some embodiments, the instrument pod210 may by configured for wireless communication with a power sourceand/or a controller such as a CPU or processor. The laparoscopicscaffold assembly 200 can include wireless technology for transmitting asignal. Thus, the movers 220 can be moved manually or powered remotely.

As illustrated in FIG. 9, the instrument pod 210 may be substantiallytriangularly shaped. In this manner, the instrument pod 210 may becoupled to three movers via lines extending therefrom which enablesgreater mobility thereof. This permits movement along the x-axis and they-axis (see FIG. 10). That is, the pod 210 can be moved along the axisof the lines somewhat horizontal to the body cavity. The provision ofthree lines increases the stability of the platform. In someembodiments, the instrument pod may be formed of any suitable circularor noncircular shape (e.g. polygonal such as square, pentagonal, etc.),each of which may be operably connectable to any number of moversassociated therewith to provide enhanced mobility.

Referring now to FIGS. 10-12, the plurality of movers 220 each includean anchoring portion 230 and a moving portion 240 that may be manuallyoperable or electrically operable or fluid powered. As best shown inFIGS. 11-12, the anchoring portion 230 includes a body portion 232having a T-shaped slot 232 a, a clamp 234, and a fastener 236 so thatthe anchoring portion 230 may be affixed to a separate support “S” (e.g.a table or a ledge). The fastener 236, which operably couples the clamp234 and the body portion 232, approximates and unapproximates the clamp234 to the separate support “S” upon rotation of the fastener 236 sothat the moving portion 240 and the anchoring portion 230 can beremovably affixed to the separate support “S.”

As shown in FIG. 11, the moving portion 240 includes an anchor 242 forengaging the slot 232 a so that the moving portion 240 may be removablyaffixed to the anchoring portion 230 for interchanging or replacingmoving portions 240 of movers 220 a, 220 b, 220 c with respect to eachanchoring portion 230. The moving portion 240 of each mover 220 a, 220b, 220 c includes a crank 244 a, a spool 246, a base 248, and the one ormore lines 249. The movers 220 a, 220 b, and 220 c can be manuallyoperable, electrically operable or both manually and electrically. Theycan also be fluid powered. By way of example, in the embodimentillustrated in FIG. 10, mover 220 a has a crank 244 a that iselectrically operably, while mover 220 b has a crank 244 b that iselectrically and manually operable, and mover 220 c has a crank 244 cthat is only manually operable.

In some embodiments, electrically operable movers 220 a, 220 b may beoperably coupled to a power source and a controller as illustrated inFIG. 10 or may be battery operated and actuable via one or more switches(not shown) to cause the spool 246 thereof to rotate, the one or morelines 249 to extend and retract, and the instrument pod 210 to movebetween the movers 220 a, 220 b, 220 c. The manually operably movers 220b, 220 c may include a knob 221 or a handle 223 for rotating the spool246 thereof. Accordingly, each crank 244 and spool 246 is rotatablymounted to the base 248. The line 249 is operably coupled to the spool246 such that upon rotation of the crank 244, the line 249 extends andretracts with respect to the spool 246. In some embodiments, the one ormore lines 249 may include one or both of a fiber optic wire/cable or anelectrical wire/cable, each of which may be housed within the one ormore lines 249. In addition, the one or more lines 249 may be operablyconnected to a central processing unit “CPU” controller for selectivelyoperating the laparoscopic scaffold assembly 200. Instead of a spool asdescribed above, pinch rollers, timing belts, sprockets, and/or linearactuators such as air cylinders or solenoids, or other mechanisms, canbe used to extend and retract the lines.

With reference to FIGS. 13-14, each line 249 may include an attachmentfeature such as the cylindrical shaped attachment feature 249 a or thehalf cylindrical attachment feature 249 b illustrated therein. Eachattachment feature is configured to removably engage a port 212 (FIG. 9)in a side wall of pod 210 such as ports 212 a, 212 b of the instrumentpod 210 such that the instrument pod 210 and each mover 220 are operablyconnected. As described above, ports 212 a, 212 b may include one ormore universal serial buses (USB), serial ports, or parallel ports tosend and receive signals to and from a power source and/or a controller.

Another embodiment of an instrument pod 310 is shown in FIG. 15. In thisembodiment, the instrument pod 310 includes a body portion 310 a havinga pair of catches 312, 314 extending from the distal ends thereof and aninstrument slot 316 configured to slidably receive a plurality offunctional accessories. For example, instrument slot 316 may beconfigured to receive first accessory assembly 320 which includes asensor 322. Similarly, instrument slot 316 may be configured to receivesecond accessory assembly 330 which includes a camera 332 and a surgicalinstrument engaging clip 334 for selectively affixing a plurality ofsurgical instruments thereto. However, any suitable instrument may beaffixed thereto including an illumination source, a grasper, aretractor, a sensor, etc.

Referring now to FIGS. 16-19, an alternate embodiment of an instrumentpod 400 includes a body portion 410 substantially triangular inconfiguration in the expanded condition. Body portion 410 has aplurality of sections 410 a, 410 b, 410 c pivotably mounted thereto viaa hinge 414 such that the instrument pod 400 is positionable between acollapsed condition (FIG. 18) for insertion through an access port orbody opening into the body cavity and an expanded condition (FIG. 16).Each section 410 a, 410 b, 410 c includes one or more ports 412 foroperably coupling to one or more movers 220 a, 220 b, 220 c in the moversimilar to pod 210 discussed above. Each section 410 a, 410 b, 410 cincludes one or more instruments “I” (e.g., a camera, an illuminationsource, a grasper, a retractor, and a sensor) for performing a surgicalprocedure within a body cavity “BC.”

It should be appreciated that a various number of moves can be utilizedto provide the platform of the present disclosure. For example, insteadof two movers, one mover and a spring can be provided. Additionally,instead of three movers, two movers and one or more springs could beprovided. Also the pods can be of different shapes than shown.

While several embodiments of the disclosure have been shown in thedrawings, it is not intended that the disclosure be limited thereto, asit is intended that the disclosure be as broad in scope as the art willallow and that the specification be read likewise. Therefore, the abovedescription should not be construed as limiting, but merely asexemplifications of particular embodiments. Those skilled in the artwill envision other modifications within the scope and spirit of theclaims appended hereto.

1. A scaffold assembly for minimally invasive surgery, comprising: aninstrument pod configured for insertion through a tissue tract into abody cavity; and a plurality of actuatable movers each including aninsertion portion extending therefrom for insertion within tissue, eachmover having at least one line removably attachable to the instrumentpod and configured to move the instrument pod between differentpositions relative to each mover upon the actuation of at least one ofthe movers to move the instrument pod within the body cavity.
 2. Alaparoscopic scaffold assembly of claim 1, further comprising at leastone instrument operably coupled to the instrument pod wherein the atleast one instrument is suspended within the body cavity.
 3. Thelaparoscopic scaffold assembly of claim 1, wherein the instrument pod ismovable between a first collapsed configured for insertion into the bodycavity and a second expanded configuration.
 4. The laparoscopic scaffoldassembly of claim 1, wherein each mover is manually or actuable.
 5. Thelaparoscopic scaffold assembly of claim 1, wherein each mover iselectrically actuable.
 6. The laparoscopic scaffold assembly of claim 1,wherein the instrument pod has an elongated configuration having firstand second opposing end portions and a line of a first of the movers isattached at the first end portion and a line of a second of the moversis attached at a second end portion.
 7. The laparoscopic scaffoldassembly of claim 1, wherein the plurality of movers comprises threemovers and the instrument pod has a substantially triangularconfiguration, a line of each of the movers attached adjacent a vertexof the instrument pod.
 8. The laparoscopic scaffold assembly of claim 2,wherein the at least one instrument includes at least one of a camera,an illumination source, a grasper, a retractor, and a sensor.
 9. Thelaparoscopic scaffold assembly of claim 1, wherein at least one moverincludes a rotatable member operably associated with the at least oneline.
 10. The laparoscopic scaffold assembly of claim 1, wherein the atleast one mover includes a rotatable actuator operably associated withthe at least one line.
 11. The laparoscopic scaffold assembly of claim1, wherein at least one mover includes a linear actuator operablyassociated with the at least one line.
 12. The laparoscopic scaffoldassembly of claim 1, wherein the at least one line includes at least oneof a fiber optic wire/cable or an electrical wire/cable which operablycouples to at least one port of the instrument pod.
 13. The laparoscopicscaffold assembly of claim 12, wherein the at least one line is operablyconnected to a CPU controller.
 14. The laparoscopic scaffold assembly ofclaim 1, wherein the at least one line is adapted for movement throughthe cannula of one of the respective movers.
 15. The laparoscopicscaffold assembly of claim 1, wherein the at least one instrument isselectively operable within the body cavity.
 16. The laparoscopicscaffold assembly of claim 1, wherein the instrument pod is selectivelymovable between two movers.
 17. The laparoscopic scaffold assembly ofclaim 1, wherein the instrument pod is selectively movable between threemovers.
 18. A method of movably suspending an instrument pod within abody cavity, comprising: providing a scaffold assembly, comprising:indent an instrument pod including at least one instrument operablyassociated therewith; and a plurality of movers, each mover including atissue insertion member and at least one line extending therefrom, theat least one line being selectively extendable and retractable from eachrespective mover; inserting the instrument pod into a body cavity;attaching the at least one line of at least one of the movers to theinstrument pod while the instrument pod and the at least one line arepositioned within the body cavity; and selectively extending orretracting the at least one line such that the instrument pod moveswithin the body cavity.
 19. The method of claim 18, further comprisingthe step of selectively moving the instrument pod within the body cavitybetween two movers.
 20. The method of claim 18, further comprising thestep of selectively moving the instrument pod within the body cavitybetween three movers.
 21. The method of claim 18, further comprising thestep of selectively operating the at least one instrument within thebody cavity wherein the at least one instrument includes at least one ofa camera, an illumination source, a grasper, a retractor, and a sensor.